My turn to ask--What do YOU thnk?

PSM,

LOL!  My turn to try to help YOU!  Do you know of any neuropsych who will take Medicaid?  I, too, would feel uncomfortable taking her to a ped for a dx because they really aren't trained in the same way to tease all these disorders out.  I love our ped -- and I respect his opinion immensely -- but he would never even attempt to dx a child with any disorder.  He ALWAYS refers to neuropsychs for dx of childhood disorders.

Given her symptoms, it could be ADD and it may not be.  As you well know, there are many disorders that cause inattention (including LDs, which she has).  Has she had an outside full evaluation by a speech and language pathologist?  That may give you SOME answers.  Having said that, there are tests neuropsychologists can do that can actually evaluate for disorders of attention.  My 10-year-old daughter has suspected bipolar disorder.  Before that unofficial dx came from the pdoc last week, we had her evaluated by a neuropsychologist over the summer.  He did two computerized tests -- the CPT-II (a 14-minute test that measures sustained visual attention) and the TEA-Ch Code Transmission (a 12-minute test of sustained visual attention).  While she scored very low on the impulsivity factor, she scored high average and above on the attention factor.  He, therefore, concluded that she does not have a disorder of attention.  My ADHD son, on the other hand, scored well below average on these tests, as you would expect.

BTW, girls are generally more difficult to diagnose precisely for the reason you note -- they are compliant in school and don't display a lot of the impulsive behaviors boys do.  So it is trickier to figure it all out. 

Anyway, hope that helps.  Keep us posted on what you decide to do.

psm, it's so strange to have you ask a question!  I look to you for answers so much of the time.   A med may help her focus and be able to concentrate on what the teacher is saying.  (My friend's son isn't dx'd, but he takes a pill every morning before school and it has helped him A LOT.  His grades have improved quite a bit since starting the med.)  She must be a bright girl - being able to focus would probably help her catch up. 

I don't know anything about sensory disorders, but with her sensitivity, maybe that's something to look into. 

I hope you find some answers soon!  Keep us posted!

PSM

My son has ADD.  He is not hyper, but he has a lot of trouble with focus.  He was never a disciplint problem is school, but on his report card his teachers would write  "Matthew will do better in class when his listening skills improve".  His mind wanders and he needs you to give him instructions in small doses.  His teachers sit right next to him and help redirect him when he gets off task.  He can be a really frustrating child to deal with because he has the brains but it seems like his motivation is totally lacking.  He seems lazy, even though he isn't.  At school the teachers say that he "lacks self confidence" because when he is given work that overwhlems him he cries and says that he can't do it.  Matt does not struggle with self-confidence.  He has just learned that if he cries and says that he can't do it then teachers step up to help him.  I am trying to help him learn how to ask for help rather than having a melt down.

Matthew's teachers did not believe that he had ADD.  In fact every single one of them told me that he had maturity issues.  That when he matured he would be fine.  But I kept getting these report cards that consistently said the same things over and over.  I got really upset because I felt like his intellect was not reflected in his performance.  I felt like I wasn't getting a good answer for it.  So I decided to have him evaluated for ADD.  First I bought a book about ADD and read one of the example cases of ADD and I was reading about my child.  So I took him to the pediatrician who said that Matt's issues were environmental. Matt's dad is a cracker and he thought that Matt was just imitating his dad.  In fact his dad was at the appointment and he was saying how I just was too uptight etc.  So the doc patted me on the back and told me that everythign was fine, but that he would do the teacher evaluations. 

One of Matt's teachers (the reading resource teacher) has kids and used the same doc.  The pediatrician called her and she totally backed me and said that matt did have issues and that she was so glad that I finally did soemthing. 

So with nothing more than that Matt was diagnosed with ADD.   The pediatrician acted like the stims were a miracle cure for ADD and we happily gave Matt the meds without ever questioning.

Needless to say it was not the best start for a diagnosis and medication regime .. HOWEVER .. the stims are a godsend for us.  Yes, we struggle with wieght.  Yes, I have to watchi his moods.  Yes, we have faced the frustration of one med becomign ineffective and having to make the inevitable switch.  BUT .. they help him focus.  He is totally caught up with his class.  He is more stable in school.  He is learning. 

Since then we have been to a neurologist and a neuro-psych so I know we have the right diagnosis.  But we got lucky, because we got it right, right in the beginning and the meds worked for us.

My dd, now 13, was diagnosed last year by her pediatrician as ADD.  Before that time I had her tested at school (in 4th grade) but she did not qualify for any special services.  Subsequently I had her tested for auditory processing problems but again they found no problems.  Her primary problem in school was reading comprehension.  She could read the words just fine or even tell you what a particular sentence was about; however, if asked to read anything more or longer, she would have absolutely no idea what she had just read.  Title I at school and several dollars at Sylvan Learning Center were somewhat helpful but did not really address the comprehension problem. 

Other things we noticed included but were not confined to:  difficulty remembering instructions particularly if more than one step or item was involved,  brought home almost every book in her locker because she couldn't remember if she had homework and what she would need to complete it, sleep problems, no sense of time, just didn't "get" it (jokes, story lines, etc. without elaborate explanations), never enjoyed being read to, never enjoyed coloring or any other activity that took "time", late or missing homework assignments, poor understanding of consequences and poor judgment.

Every year school was becoming increasing more of a problem and I finally decided we had to try something.  I had my suspicions about ADD and approached our pediatrician about them.  He prescribed Adderal XR which she has taken every day since then.  The improvement was immediate.  Because it was so immediate and pretty dramatic I did not pursue an evaluation by a neuropsych or other professional.

Are things perfect here - no.  But, she's making all As and Bs in school and is currently having not problems in the homework area.  We still need some work on making good choices, moodiness, better empathy, sullen responses, argumentativeness especially in regard to me, her mother.  Not sure how much of this is ADD and how much is typical teenager.  She appears to be getting along well with teachers and classmates so I guess it is, in part, a mother/daughter personality thing.  Today in particular I'm a little "down" about our interaction over the weekend and so it is difficult for me to be objective.  She is doing well but I wish we could "connect" better and enjoy one another's company more.

I don't regret for a moment the decision to try medication.  It has truly been life altering.  It broke my heart to watch her increasing play the role of class clown in an effort to cover up.     

Just adding my two cents.  go with your mother's instinct.  If you think something is wrong, check it out.  Last year, my daughter (4th grade) was diagnosed ADD.  She was put on low level concerta (18mg).   In a week, there was such a change in her ability to focus.  The yelling at homework time stopped.  She was able to talk much more fluidly.  We didn't tell the school about her diagnosis.  A few weeks after starting her meds, her teacher told me that it seemed that Katie was paying a lot more attention in class.  I just shrugged my shoulders and said 'wonder why'.  I didn't want her teacher last year to know so we could have an unbiased opinion from the school.  This year I told her teacher.  My husband was also unsupportive when I brought up that maybe she had a problem.  After she started meds, he had to admitt that yes she had a probem and that yes the pills were helping.  Medicating her wasn't easy to do, and over the summer we had her off her pills, but i think overall, it makes her quality of life better.  She gets so much more of out her activities when he pays full attention to what's going on around her.